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Human Cutaneous Leishmaniasis Acquired in Texas^*

Tracy L. Gustafson, Christie M. Reed, Patrick B. McGreevy, Michael G. Pappas, J. Carl Fox AND Phillip G. Lawyer^¶

Bureau of Epidemiology, Texas Department of Health, Austin, Texas
Walter Reed Army Institute of Research, Washington, D.C.
Oklahoma State University College of Veterinary Medicine, Stillwater, Oklahoma
^¶ U.S. Army Medical Department Student Detachment, University of Florida, Gainesville, Florida

Four cases of autochthonous human cutaneous leishmaniasis have been identified in south-central Texas since 1980. The patients presented with chronic ulcerating papules on the face, earlobe, and lateral thigh. In two patients, the infections healed without treatment. In the other two patients, the lesions healed following treatment with intramuscular sodium stibogluconate or topical antimony potassium tartrate. Serologic testing of family members, using four different techniques, indicates that asymptomatic infections may occur. These are the first reported cases of cutaneous leishmaniasis acquired in Texas since 1974. Organisms isolated from patients in 1974 and 1980 belonged to the Leishmania mexicana complex when tested by the isoenzyme technique. Although no animal reservoir or insect vector has been identified, six species of sand flies belonging to the genus Lutzomyia do inhabit this part of Texas. Accumulated evidence strongly suggests that cutaneous leishmaniasis is endemic in south-central Texas.

Accepted for publication July 23, 1984.

^* The views of the authors do not purport to reflect the position of the Department of the Army or the Department of Defense (P. 4-3, AR 360-5).

Address reprint requests to: Tracy L. Gustafson, M.D., Bureau of Epidemiology, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756.

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